| NPI | 1134268857 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAMELA J BORVAN Vice President 815-462-8602 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology Pain Medicine |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 367500000X Nurse Anesthetist, Certified Registered | |
| Enumeration Date | 2007-02-06 |
| Last Update Date | 2022-07-21 |